Provider Demographics
NPI:1295772820
Name:ST. ALEXIUS MEDICAL CENTER
Entity type:Organization
Organization Name:ST. ALEXIUS MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TOD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-463-6505
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:TURTLE LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58575-0280
Mailing Address - Country:US
Mailing Address - Phone:701-448-2331
Mailing Address - Fax:701-448-2441
Practice Address - Street 1:220 5TH AVE W
Practice Address - Street 2:
Practice Address - City:TURTLE LAKE
Practice Address - State:ND
Practice Address - Zip Code:58575-4324
Practice Address - Country:US
Practice Address - Phone:701-448-2331
Practice Address - Fax:701-448-2441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC HEALTH INITIATIVES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-01
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1459093Medicaid
ND35Z304Medicare Oscar/Certification
ND35Z304Medicare Oscar/Certification